Gong Qiaoer, Xue Nianyu
Department of Ultrasound, The First Affiliated Hospital of Ningbo University, Ningbo, China.
AME Case Rep. 2024 Jul 2;8:77. doi: 10.21037/acr-24-21. eCollection 2024.
Intravenous leiomyomatosis (IVL) is a special type of uterine leiomyoma and is rare. Intravenous lipoleiomyomatosis (LPL) is a rare subtype of IVL, distinguished by the presence of adipose tissue. Although histologically benign, this disease exhibits aggressive biological behavior such as local invasion and high recurrence rate. The disease initially presents with no obvious clinical features, and cardiac symptoms may only appear in the later stages. Diagnosis primarily relies on imaging studies, and due to its rarity and atypical clinical presentation, imaging diagnosis can be challenging, leading to misdiagnosis and missed diagnosis. Previously, there was no report on the imaging findings of this disease.
This article reports a case of a 52-year-old patient who presented with lower abdominal discomfort due to IVL, and who underwent surgical resection and had a good recovery.
This is the first time we report the imaging features of a disease of intravenous LPL with an extension of the inferior vena cava (IVC), and its characteristic imaging features [ultrasound shows a mass with high echogenicity, computed tomography (CT) shows low-density signal similar to fat, magnetic resonance imaging (MRI) shows high signal on T1-weighted (T1W) image and low signal on T1W with fat-suppression (T1FS)] can lead to an accurate preoperative diagnosis and guide clinical treatment.
静脉内平滑肌瘤病（IVL）是一种特殊类型的子宫平滑肌瘤，较为罕见。静脉内脂肪平滑肌瘤病（LPL）是IVL的一种罕见亚型，其特征是存在脂肪组织。尽管在组织学上为良性，但该疾病表现出侵袭性生物学行为，如局部侵袭和高复发率。该疾病最初无明显临床特征，心脏症状可能仅在后期出现。诊断主要依靠影像学检查，由于其罕见性和非典型临床表现，影像学诊断具有挑战性，易导致误诊和漏诊。此前，尚无关于该疾病影像学表现的报道。
本文报告一例52岁因IVL出现下腹部不适的患者，该患者接受了手术切除且恢复良好。
这是我们首次报告静脉内LPL伴下腔静脉（IVC）受累疾病的影像学特征，其特征性影像学表现[超声显示高回声团块，计算机断层扫描（CT）显示类似脂肪的低密度信号，磁共振成像（MRI）在T1加权（T1W）图像上显示高信号，在脂肪抑制T1加权（T1FS）图像上显示低信号]可导致准确的术前诊断并指导临床治疗。
